36D2147441 CLIA NUMBER - VANCREST OF PAYNE

Laboratory Demographics

  • CLIA Code: 36D2147441
  • Facility Name: VANCREST OF PAYNE
  • Facility Address: 650 N MAIN STREET
    PAYNE, OH
    ZIP 45880
  • Facility Phone: 419 263-0191
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MARTHA BRADFORD
  • NPI Number: 1609363241
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 36D2147441
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name VANCREST OF PAYNE
Street 650 N MAIN STREET
City PAYNE
State OH
ZIP 45880
Phone 419 263-0191
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/19/2024
Certificate Expiration Date 4/18/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MARTHA BRADFORD

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This page was last updated on: 6/4/2025